Article Impact Level: HIGH Data Quality: STRONG Summary of International Journal of Gynecology & Obstetrics, ijgo.15856. https://doi.org/10.1002/ijgo.15856 Dr. Hyun Ju Jeong et al.
Points
- A 14-year study analyzed 646 patients with a presumptive diagnosis of interstitial cystitis (IC), uncovering significant incidental findings through comprehensive diagnostic evaluations.
- The study identified 14 cases (2.2%) of genitourinary malignancies, including 13 bladder cancers and one prostate cancer, along with 7 cases (1.1%) of urinary tuberculosis.
- The diagnostic protocol emphasized thorough screenings, including physical exams, urinalysis, PSA testing in men over 50, advanced imaging (ultrasound and CT), and observational cystoscopy.
- Tuberculosis testing and continuous evaluation demonstrated the importance of excluding other diseases, especially in patients with suspected IC.
- The findings underscore the critical need for detailed initial assessments and long-term follow-up to detect other conditions like cancer and tuberculosis in IC patients.
Summary
In a comprehensive study over 14 years, researchers investigated the process and outcomes of excluding confusable diseases in patients with presumptive interstitial cystitis (IC) diagnosis. The study identified significant incidental findings by utilizing retrospective analysis of electronic medical records from 646 patients (164 men and 482 women) who underwent observational cystoscopy under suspicion of IC at Seoul National University Hospital. Notably, 14 patients (2.2%) were diagnosed with genitourinary tract malignancies, including 13 with bladder cancer and 1 with prostate cancer, and seven patients (1.1%) were diagnosed with urinary tuberculosis, indicating the critical importance of meticulous differential diagnosis in suspected IC cases.
The diagnostic protocol for patients presenting with pelvic pain included a thorough initial workup with emphasis on ruling out other potential causes, such as malignancies or infections, particularly urinary tuberculosis. The study highlighted various diagnostic tools, including physical examinations, urinalysis, serum prostate-specific antigen measurements in men over 50, and advanced imaging techniques such as ultrasonography and computed tomography. Additionally, tuberculosis testing and observational cystoscopy were essential components of the diagnostic process, reflecting the complexity and necessity of comprehensive screening to ensure accurate IC diagnosis.
The findings underscore the necessity of continuous vigilance in following up on patients with suspected IC, even after initial examinations fail to detect other diseases. The significant discovery of bladder tumors and tuberculosis in patients initially assessed for IC demonstrates the dynamic nature of diagnostic medicine and the need for ongoing evaluation. This study not only reaffirms the importance of excluding confusable diseases in the diagnosis of IC but also highlights the potential improvements in patient care through detailed initial assessments and vigilant long-term follow-up.
Link to the article: https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.15856
References Jeong, H. J., Kang, Y. J., Choo, M. S., Jeong, S. J., & Oh, S. (2024). Excluding confusable diseases in patients with presumptive diagnosis of interstitial cystitis: A large patient cohort study. International Journal of Gynecology & Obstetrics, ijgo.15856. https://doi.org/10.1002/ijgo.15856
